Abstract

Introduction

Accelerated cardiovascular (CV) disease significantly contributes to increased mortality
in rheumatoid arthritis (RA) patients, with a risk comparable to the one observed
in patients with type 2 diabetes mellitus (DM). Part of this enhanced risk in RA is
attributed to traditional cardiovascular risk factors (CRFs). The aims of this study
were to determine how often traditional CRFs are identified and managed by (a) rheumatologists,
compared with primary care physicians (PCPs) in RA patients; and (b) PCPs among patients
with RA, DM, and the general population (GP).

Methods

A retrospective cohort study compared age/gender/ethnicity-matched patients from three
groups: RA, DM, and GP (without RA or DM); n = 251 patients per group. Electronic patient records were reviewed during a continuous
12-month period between June 2007 and April 2011 to assess whether CRFs were identified
and managed.

Results

In RA patients, PCPs managed obesity, BP, and lipids significantly more often than
did rheumatologists. PCPs managed obesity, BP, and lipids significantly more often
in diabetic patients than in the other two groups, and more often in the GP than in
RA patients. In patients with elevated BMI, PCPs managed weight in 68% of the DM group,
46% of the GP, and 31% of the RA group (P < 0.0001 for all groups; P = 0.006 between RA and GP groups).

Conclusions

Rheumatologists identify and manage CRFs less frequently than PCPs. PCPs manage CRFs
less frequently in RA patients, compared to the GP and DM. Given the increased CV
risk associated with RA, physicians need to more aggressively manage CRFs in these
patients.